Zoë Hyde1, Leon Flicker1, Kate Smith1, David Atkinson2, Stephen Fenner3, Linda Skeaf4, Roslyn Malay4, Dina Lo Giudice5. 1. Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Australia. 2. Rural Clinical School of WA, University of Western Australia, Perth, Australia; Kimberley Aboriginal Medical Services, Broome, Australia. 3. Department of Psychiatry, Royal Perth Hospital, Perth, Australia. 4. Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia. 5. Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia; Aged Care Department, Melbourne Health, Melbourne, Australia. Electronic address: dina.logiudice@mh.org.au.
Abstract
OBJECTIVES: Frailty represents a loss of homeostasis, markedly increasing the risk of death and disability. Frailty has been measured in several ethnic groups, but not, to our knowledge, in Aboriginal Australians. We aimed to determine the prevalence and incidence of frailty, and associations with mortality and disability, in remote-living Aboriginal people. STUDY DESIGN: Between 2004 and 2006, we recruited 363 Aboriginal people aged ≥ 45 years from 6 remote communities and one town in the Kimberley region of Western Australia (wave 1). Between 2011 and 2013, 182 surviving participants were followed-up (wave 2). We assessed frailty with an index, comprising 20 health-related items. Participants with ≥ 4 deficits (frailty index ≥ 0.2) were considered frail. Disability was assessed by family/carer report. Those unable to do ≥ 2 of 6 key or instrumental activities of daily living were considered disabled. We investigated associations between frailty, and disability and mortality, with logistic regression and Cox proportional hazards models. RESULTS: At wave 1 (W1), 188 participants (65.3%) were frail, and of robust people at W1 who participated in wave 2, 38 (51.4%) had become frail. Frailty emerged at a younger age than expected. A total of 109 people died (30.0%), of whom 80 (73.4%) were frail at W1. Frailty at W1 was not associated with becoming disabled, but was associated with mortality (HR = 1.9; 95% CI 1.2, 3.0). CONCLUSIONS: Frailty in remote-living Aboriginal Australians is highly prevalent; substantially higher than in other populations. Research to understand the underlying causes of frailty in this population, and if possible, reverse frailty, is urgently needed.
OBJECTIVES: Frailty represents a loss of homeostasis, markedly increasing the risk of death and disability. Frailty has been measured in several ethnic groups, but not, to our knowledge, in Aboriginal Australians. We aimed to determine the prevalence and incidence of frailty, and associations with mortality and disability, in remote-living Aboriginal people. STUDY DESIGN: Between 2004 and 2006, we recruited 363 Aboriginal people aged ≥ 45 years from 6 remote communities and one town in the Kimberley region of Western Australia (wave 1). Between 2011 and 2013, 182 surviving participants were followed-up (wave 2). We assessed frailty with an index, comprising 20 health-related items. Participants with ≥ 4 deficits (frailty index ≥ 0.2) were considered frail. Disability was assessed by family/carer report. Those unable to do ≥ 2 of 6 key or instrumental activities of daily living were considered disabled. We investigated associations between frailty, and disability and mortality, with logistic regression and Cox proportional hazards models. RESULTS: At wave 1 (W1), 188 participants (65.3%) were frail, and of robust people at W1 who participated in wave 2, 38 (51.4%) had become frail. Frailty emerged at a younger age than expected. A total of 109 people died (30.0%), of whom 80 (73.4%) were frail at W1. Frailty at W1 was not associated with becoming disabled, but was associated with mortality (HR = 1.9; 95% CI 1.2, 3.0). CONCLUSIONS: Frailty in remote-living Aboriginal Australians is highly prevalent; substantially higher than in other populations. Research to understand the underlying causes of frailty in this population, and if possible, reverse frailty, is urgently needed.
Authors: Zoë Hyde; Kate Smith; Leon Flicker; David Atkinson; Osvaldo P Almeida; Nicola T Lautenschlager; Anna Dwyer; Dina LoGiudice Journal: PLoS One Date: 2018-04-05 Impact factor: 3.240
Authors: Gemma F Spiers; Tafadzwa Patience Kunonga; Alex Hall; Fiona Beyer; Elisabeth Boulton; Stuart Parker; Peter Bower; Dawn Craig; Chris Todd; Barbara Hanratty Journal: BMJ Open Date: 2021-03-22 Impact factor: 2.692
Authors: Richard Ofori-Asenso; Ken L Chin; Mohsen Mazidi; Ella Zomer; Jenni Ilomaki; Andrew R Zullo; Danijela Gasevic; Zanfina Ademi; Maarit J Korhonen; Dina LoGiudice; J Simon Bell; Danny Liew Journal: JAMA Netw Open Date: 2019-08-02